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Monday, 8 February 2010
Page: 796


Mr SIMPKINS (8:30 PM) —In January, I had a conversation with an education assistant who works with special needs children in a school in my electorate of Cowan. Amongst other matters she told me about her thoughts on foetal alcohol syndrome. Foetal alcohol syndrome is a disorder that affects the foetus when the mother uses alcohol. The alcohol can cross the placenta barrier and stunt growth and weight. It causes damage to neurons and brain structures. Foetal alcohol syndrome results in physical, mental and/or behavioural problems.

As a consequence of that conversation, with the assistance of the Parliamentary Library I undertook some research into the syndrome and more broadly foetal alcohol spectrum disorder. I used to think that a pregnant woman drinking alcohol would put her child at risk of low birthweight and delayed development. Overall I was under an incorrect assumption that the problems were temporary and therefore I did not appreciate the highly negative and permanent outcomes involved. I would emphasise that my wife and, as I recall, my wife’s friends all abstained from alcohol during their pregnancies. I pretty much thought that everybody did, but I was wrong.

It was in the 1970s that the term ‘foetal alcohol syndrome’ was first used to describe a range of physical malformations in children exposed alcohol in utero. These abnormal features include growth retardation, characteristic facial features and central nervous system anomalies which include intellectual impairment. These features occur only in the extreme cases where mothers have had a history of heavy use of alcohol. ‘Alcohol related birth defects’ is another term used to describe those effects of alcohol where only some of the features that I have already described can be found. Similarly, the most common term used to describe the range of outcomes of alcohol use in pregnancy is ‘foetal alcohol spectrum disorders’.

There is no doubt that there is varying research regarding the amount of alcohol consumption that takes place to cause less severe forms of foetal alcohol syndrome. However, the evidence is clear on the link between heavy drinking and the severe categories of foetal alcohol syndrome. As is so often the case, when doubt is expressed as to the level at which alcohol consumption becomes dangerous with reference to foetal alcohol syndrome, that may serve to make some people drop their guard on the matter. The point is that the only no-risk option is to abstain from any use of alcohol. Even minimal use introduces some level of risk to the healthy development of a child.

The question then becomes: how widespread is this problem? It is in fact very difficult to separate foetal alcohol syndrome from other developmental problems as a result of the difficulty in achieving an accurate diagnosis. Recognising the symptoms at the earliest stages is difficult, so may be some years later that the questions are asked and therefore made more difficult by recall bias, quantification of alcohol consumption, case ascertainment and analysis of alcohol consumption averaged to daily or weekly intake. It is also worth noting that general practitioners and even specialist paediatricians apparently have limited knowledge with regard to the identification and management of foetal alcohol related problems. Diagnosis is difficult because it does require the mother to admit to misusing alcohol, and the problems may also be an outcome of drug use. The problem is also that symptoms of foetal alcohol syndrome can also look like autism, attention deficit disorder, attention deficit hyperactivity disorder or even Asperger’s. The outward physical characteristics of a child with foetal alcohol syndrome are a small head circumference, small eye openings, small midface, a thin upper lip, skin folds at the corner at the corner of the eye, a low nasal bridge, a short nose and an indistinct groove or philtrum between the nose and the upper lip.

Foetal alcohol syndrome should worry us all. It results in permanent problems for a child inflicted by the pregnant mother’s reckless or ignorant use of alcohol. We should be very concerned and look for ways to discourage the use of any amount of alcohol during pregnancy. Figures in a fairly recent studies suggest that 50 per cent of Australian women used alcohol during their pregnancies and about 15 per cent drank alcohol at risky levels. That means that one in every two Australian women are risking permanent central nervous system damage and the other range of symptoms of foetal alcohol syndrome for the unborn child. This can occur because the brain of the child is damaged by the alcohol, resulting in underdevelopment or malformation. The cognitive and functional disabilities which can include poor memory, attention deficits, impulsive behaviour and poor cause-effect reasoning will result in a lifetime of problems for the child and ultimately for our society.

Foetal alcohol syndrome can also result in mental health problems and drug addiction. The reality is that there is no safe period during the pregnancy and no safe amount of alcohol, because the baby’s brain develops throughout the pregnancy. If we examine the outcomes of foetal alcohol syndrome versus the risk accepted by 50 per cent of mothers, we should be very worried. Questions to be asked by doctors when they are thinking about the diagnosis of a child with ADHD should include how much alcohol was consumed during pregnancy.

As a father, I worry a lot for my children. I also want the children in Cowan and across the entire country to grow up healthy and with all the opportunities they deserve to succeed in this nation. I have been critical in the past of those parents that do not encourage their children to work hard at school and be the very best they can be. I also believe that there should be more permanent adoption of children who live in negative environments involving illicit drugs or crime in order for them to be saved from the bad examples inflicted upon them by those who should not be parents.

What is truly tragic in the case of foetal alcohol syndrome, and also in those cases where illicit drugs are passed to unborn children in utero, is that we cannot save those children from the failure inflicted upon them by the actions of their mothers. We cannot take them out of the unsafe environment, which we could if they had already been born. In this matter regarding foetal alcohol syndrome, children are damaged through no fault of their own, and through either ignorance or reckless indifference their futures are being undermined. While we may lament the lack of licences for parenting, the reality is that we must look towards education and warnings about the risks involved in the hope that alcohol use will be recognised as a risky option by pregnant women and, of course, by their partners. Certainly it is too late to cover the subject in antenatal classes and it may well be that emphasis on the problem would best be covered in high school health classes.

It seems that in this modern age there are a lot of behavioural problems: graffiti, hooning, antisocial behaviour and in some respects more violent crime. We have more and more diagnoses of disorders such as autism, Asperger’s, attention deficit disorders and hyperactivity generally. Maybe there is a reason behind these changes in our society. Maybe it is our own mistakes that contribute in part to these problems. I am not saying that every case of misbehaviour or misdiagnosed ADHD or autism is in fact foetal alcohol syndrome. I am not saying that pregnant women drinking alcohol are responsible for bearing damaged children who then create problems in our society and who themselves will never do as well as they could have because of their mothers. But I am saying that some small number of pregnant women have undermined and are undermining their children’s futures and costing society through their recklessness or ignorance of the risks involved with drinking alcohol.

As parents we have our responsibilities, and as citizens we also have our responsibilities. What this country needs in the future are more effective and productive young people out there achieving their potential and contributing to Australia’s future. What we do not need is more people on the disability support pension, on the dole, in jail or in need of additional support just because their parents did not know or did not care that drinking alcohol risked giving their unborn child major cognitive and reasoning impairments.

While we as a society should put up the warning signs, maybe more brightly than we have before, parents should also accept responsibility. I therefore call on the government to require the doctor at the time a pregnancy is confirmed to give the woman—or in fact the woman and partner—a warning leaflet about the risks of foetal alcohol syndrome and that that warning be noted. I would also like to see more consideration given to what else could be done to address this problem. Although these suggestions would be difficult to administer, I would like to see any means whereby parents are made to be accountable for undermining their children’s future.

While I am out meeting people in Cowan and we talk about graffiti, vandalism, hooning and other antisocial or violent behaviour, a lot of older residents say to me, ‘It never used to be like this.’ I wonder whether we are now reaping the outcomes of a possibly self-inflicted injury, an indulgence of reckless indifference or ignorance that will bring a heavy burden to families and ultimately to our society. What is the link between drinking during pregnancy and our societal problems? This seems to be a question worth asking.